Open Access Research article

Use of health systems evidence by policymakers in eastern mediterranean countries: views, practices, and contextual influences

Fadi El-Jardali123*, John N Lavis4567, Nour Ataya1, Diana Jamal1, Walid Ammar1 and Saned Raouf1

Author Affiliations

1 Department of Health Management and Policy, American University of Beirut, Room 107C, PO Box 11–0236, Riad El Solh, Beirut, 1107 2020, Lebanon

2 McMaster Health Forum, MML-417, 1280 Main St. West, Hamilton, Ontario, L8S 4L6, Canada

3 Research, Advocacy and Public Policy-making, Issam Fares Institute for Public Policy and International Affairs, American University of Beirut, Box 11–0236, Riad El Solh, Beirut, 1107 2020, Lebanon

4 McMaster Health Forum, MML-417, 1280 Main St. West, Hamilton, Ontario, L8S 4L6, Canada

5 Centre for Health Economics and Policy Analysis, McMaster University, CRL-209, 1280 Main St. West, Hamilton, Ontario, L8S 4K1, Canada

6 Department of Clinical Epidemiology and Biostatistics, McMaster University, CRL-209, 1280 Main St. West, Hamilton, Ontario, L8S 4K1, Canada

7 Department of Political Science, McMaster University, CRL-209, 1280 Main St. West, Hamilton, Ontario, L8S 4K1, Canada

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BMC Health Services Research 2012, 12:200  doi:10.1186/1472-6963-12-200

Published: 16 July 2012

Abstract

Background

Health systems evidence can enhance policymaking and strengthen national health systems. In the Middle East, limited research exists on the use of evidence in the policymaking process. This multi-country study explored policymakers’ views and practices regarding the use of health systems evidence in health policymaking in 10 eastern Mediterranean countries, including factors that influence health policymaking and barriers and facilitators to the use of evidence.

Methods

This study utilized a survey adapted and customized from a similar tool developed in Canada. Health policymakers from 10 countries (Algeria, Bahrain, Jordan, Lebanon Oman, Pakistan, Palestine, Sudan, Tunisia, and Yemen) were surveyed. Descriptive and bi-variate analyses were performed for quantitative questions and thematic analysis was done for qualitative questions.

Results

A total of 237 policymakers completed the survey (56.3% response rate). Governing parties, limited funding for the health sector and donor organizations exerted a strong influence on policymaking processes. Most (88.5%) policymakers reported requesting evidence and 43.1% reported collaborating with researchers. Overall, 40.1% reported that research evidence is not delivered at the right time. Lack of an explicit budget for evidence-informed health policymaking (55.3%), lack of an administrative structure for supporting evidence-informed health policymaking processes (52.6%), and limited value given to research (35.9%) all limited the use of research evidence. Barriers to the use of evidence included lack of research targeting health policy, lack of funding and investments, and political forces. Facilitators included availability of health research and research institutions, qualified researchers, research funding, and easy access to information.

Conclusions

Health policymakers in several countries recognize the importance of using health systems evidence. Study findings are important in light of changes unfolding in some Arab countries and can help undertake an analysis of underlying transformations and their respective health policy implications including the way evidence will be used in policy decisions.

Keywords:
Knowledge translation; Eastern Mediterranean region; Health systems research; Evidence- to- policy